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Published on: July 21, 2013
Acute Concurrent Cardiocerebral Infarction Associated With Trousseau Syndrome: A Case Report
Aika Okubo1, Shunya Sugai2, Kyoko Morikawa3
1Cardiology, Niigata City General Hospital, Niigata, JPN.
Abstract:
This case report describes a 66-year-old woman presenting with acute aphasia and right hemiplegia caused by multiple cerebral infarctions. Diagnostic evaluation confirmed an asymptomatic myocardial infarction (MI), as evidenced by elevated troponin I levels (3.1 ng/mL); ST-segment elevation in leads II, III, and aVF on electrocardiography; and coronary angiography showing a thrombotic occlusion in the distal portion of the left anterior descending artery. Elevated tumor markers and imaging identified stage IB endometrioid uterine carcinoma. She had a malignant tumor and multiple thrombotic events and was diagnosed with Trousseau syndrome. Management involved hysterectomy with bilateral salpingo-oophorectomy followed by chemotherapy and anticoagulation therapy, initiated with heparin and transitioned to apixaban due to the desire to minimize impact on the quality of life by using an oral medication. The patient achieved a favorable recovery without recurrent thrombotic events. To the best of our knowledge, this is the first report of a patient with Trousseau syndrome associated with stage IB uterine cancer developing acute cardiocerebral infarction (CCI). This case highlights the importance of identifying Trousseau syndrome in patients with multiple cerebral infarctions and underscores the need to screen for and asymptomatic MI, even in the absence of cardiac symptoms.
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